Introduction: Dry Eye Disease (DED) is a prevalent ocular condition characterized by insufficient tear production or excessive tear evaporation, leading to discomfort and visual disturbances. The widespread use of electronic devices has raised concerns about their potential association with DED. 

Aim: The study aimed to investigate the association between digital screen usage and DED among Orotta Collage of Medicine and Health Sciences students in Asmara, Eritrea. 

Methods: An observational cross-sectional analytical study was conducted and a total of 294 students were sampled using stratified random sampling. A pre-developed self-administered questionnaire and clinical evaluation methods were used. The data were directly entered into SPSS (version 26), and cleaned. Descriptive analysis of the socio-demographic was presented using frequencies (percentages) as appropriate – using graphs and tables. Chisquare test was used for the categorical variables. A bivariate and multivariable logistic regression analyses were used to determine predictors of dry eye. Crude Odds ratio (COR) and Adjusted Odds ratio (AOR) with 95% CI were used to measure the direction and strength of association between explanatory variables and the outcome variable. P-values less than 0.05 was considered statistically significant. 

Result: The median age of the participants was 21 years, with 86.7% of them being 25 years or less years.The distribution of students by sex was even, with 52% males and 48% females. Regarding the department, 38.1% were nursing students, while 21.8% were from the medicine department. Third-year students comprised the largest proportion (47.6%), followed by freshmen (20%). The frequency and intensity of symptoms of DED were also assessed, revealing that 25.5% of students reported problems with their eyes when watching screens often or always. Moreover, the study examined the duration of electronic device usage, finding that almost half of the students (50.3%) spent 6 to 10 hours per day using electronic devices. The prevalence of DED was computed with 29.9% of students identified as having DED. Spending 6 to 10 hours per day using electronic devices increased the likelihood of DED by 14 times compared to spending less than 5 hours. Additionally, spending more than 10 hours per day increased the likelihood by more than 45 times. However, age, sex, year of study, and department were not associated with DED. Tear film parameters were compared between students with and without DED, revealing significant differences (p<0.001) in Schirmer’s test and tear breakup time. 

Conclusion and Recommendation: This study concluded that the dry eye was prevalent as near one student in every three and directly linked to excessive use of electronic devices. Given the established link between excessive screen time and DED, implementing educational programs specifically aimed at college students becomes crucial. 

Implication to the field of nursing: Primarily, the research provided an opportunity for nurses to contribute to the growing body of knowledge in this area. Furthermore, Nurses could have played a pivotal role in raising awareness among patients about the potential risks and implementing preventive measures to minimize dry eye symptoms.